Symptoms of DPDR
Many people suffer from experiences of alienation and feelings of unreality. They feel split off from themselves and their environment. However, it is very common for experiences of alienation and feelings of unreality to go hand in hand with impairments in other areas.
The impairments suffered by people with experiences of alienation can be categorised into 7 large groups (see graphic).
Changes in body experience/self experience
For most people who suffer from alienation experiences or feelings of unreality, the experience of their own body or self is altered.
Their own body is experienced as alien, as not belonging. Sometimes the body is also experienced as unreal, as if it were not even there. This can lead to the feeling of acting like an automaton or robot without any real inner involvement.
Some sufferers have difficulty recognising themselves in the mirror.
Body boundaries can become blurred and those affected then have difficulty defining what still belongs to their body and what does not. Some people with experiences of alienation describe real out-of-body experiences. They see themselves from above or perceive themselves as a double person.
Typical statements:
‘I can’t really recognise myself in the mirror anymore. Who is that looking back at me?’
‘I feel like I’m just reacting like a robot. None of this makes any sense to me anymore.’
Impairment of sensory perception
Many people who suffer from experiences of alienation or feelings of unreality also describe impairments in their sensory perceptions.
For many, it is primarily vision that is affected. Those affected have the feeling that they are looking at events ‘from a distance’. The field of vision is restricted, those affected have tunnel vision, see dots or spots in front of their eyes. Perspective vision can also be impaired, which is why many sufferers feel unsafe in road traffic. The symptoms are particularly severe in poor lighting conditions or in the dark.
The sense of hearing can also be impaired, so that noises only sound muffled. Often even the person’s own voice sounds different.
Feeling, sensing or even tasting can also be impaired. Touch can only be felt with difficulty, food tastes bland.
Typical statements:
‘I have the feeling that I only consist of eyes. I can only feel my eyes. Nothing else is there. Just my eyes!’
‘Since the symptoms started, my voice sounds completely strange. I often can’t recognise it when I speak. I then ask myself, who is that?’
‘When I’m intimate with my girlfriend, I can’t feel anything. I know she’s doing something to my body, but it doesn’t get through to me.’
Physical complaints
Many people who experience alienation or feelings of unreality suffer from a whole range of physical complaints. Headaches and eye pain are the most common. This is mainly due to the impairment of the senses, as those affected have to make great efforts to remain productive. Exhaustion and tiredness are also very common. Many also describe dizziness, overexcitement or panic attacks.
Typical statements:
‘Something always hurts. Mostly my head and eyes!’
Emotional restrictions
For many people who have permanent or recurring experiences of alienation or feelings of unreality, their emotional experience is significantly restricted. Feelings can only be perceived in a muted way or even not at all. This is often accompanied by a loss of joie de vivre.
Typical statements:
I no longer enjoy life. How can it be fun if you don’t care about anything?’
(Irrational) fears
Experiencing alienation or feelings of unreality can be very frightening. Many sufferers describe the fear of going mad or falling apart inside. Others fear losing control in the presence of people or never waking up from this unpleasant state.
Typical statements:
‘I’m afraid that I’ll disintegrate at some point. That at some point I won’t be there at all. The symptoms will consume me completely. That’s why I always have to fight against them to at least be there for a bit.’
Restrictions in cognitive performance
Those affected by experiences of alienation or feelings of unreality often suffer from impaired cognitive performance. This includes mental restlessness, concentration problems and impaired memory. Some experience a veritable ‘brain fog’.
Brooding and circling thoughts are very common. Why am I affected of all people? Will it ever go away? Etc.
In the long term, the cognitive impairments lead to paralysing mental fatigue and a lack of motivation in many sufferers.
Typical statements:
‘It’s so difficult for me to concentrate on anything. I try, but I can’t do it. The longer I have to concentrate, the harder it is. I’m dead tired afterwards.’
Changed experience of the outside world
Just as many people with feelings of alienation or unreality perceive their own body or self differently, this is also the case with the outside world. The environment and other people are experienced as alien, ‘further away’ or unreal. It is as if the world is a big stage and people are just actors on it.
The dimension of time can also be altered. Those affected experience time faster or slower.
Typical statements:
‘Everything seems strange to me. Sometimes even my own home. How am I supposed to find my way around?’
‘Time is racing by. I can’t keep up with it. The days fly by and I haven’t done anything.’
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